what Descartes started

Enlightening would be the best word for today. The attending basically informed me that I’ve been doing something in very poor form (just surgeons’ etiquette, not patient-care related, fortunately) all month. Which was kind of crushing to find out, but at least he did tell me, and at least I know before I get to the general surgery service next month, and start annoying the attendings I’ll have to work with for five years. I also got a little more insight into exactly how useless the attendings and senior residents think interns are. Which is almost more liberating than anything else, because it means they expect us to be making dumb mistakes.

Shortly after that conversation, the medical students gave me their evaluations to fill out. I just barely managed not to say, Who, me? Evaluate you? I don’t know any more than you do! Instead I pulled myself together and gave them an encouraging evaluation, trying to be as specific as possible. There was really nothing to put for “needs to improve on.” I love these girls; yesterday we got two ridiculous consults half an hour before sign-out, and the chief sent them to see the patients and write the consults. I just had to listen to their reports, eyeball the patients, and write a few sentences on the bottom of the note. It felt so good not to be alone with those two consults at the end of the day. So any medical students reading this, I just want to let you know that even when you feel useless, you can be incredibly helpful, at least to the interns.

(One of the senior residents today was regretting the fact that her service doesn’t have an intern, and she has to see all the consults and ER patients by herself. So I guess we’re useful to them too, but I had already figured that out.)

Tomorrow is my first overnight call. No doubt I will be badly disappointed, but given the low census on some of the services right now, I’m expecting a quiet and boring day. This calls for a stash of crocheting and books in the call room.

Also, today I discovered a random training session for the computer program, and went and got the instructor to show me how to do the transfer and post-op orders that were giving me so much trouble. There were in fact, as I had hoped, a couple of functions that I hadn’t known how to use, which should make things a little faster. There’s still the slight matter of potassium having a theoretical interaction with basically every commonly used medication (from morphine to phenergan to colace), and having to go through three steps to force the computer to overlook that interaction for every single medication. But there’s no hope of persuading the bureaucrats to take that function out of there, even though the residents are now grimly joking that we’re so used to ignoring that “serious interaction” dialogue box that we probably won’t notice when a real interaction does show up.

This evening some of the residents went out together, and a drug rep footed the bill. That was the first time I ever felt personally involved in such a relationship with “big pharma.” Before, I could always put the responsibility on the doctors in whose offices the lunches showed up. But this time I was part of an agreement, and I benefited directly. I’m not sure how guilty I should feel about that. For right now, it’s more important to be part of the residents’ activities than to split ethical hairs.